1 MILLER MEDICAL PC — NPI 1568791663 (Licensed & Credentialed Allopathic & Osteopathic Physicians — Neuromusculoskeletal Medicine, Sports Medicine in FARMINGDALE, NY)

CMS-1500 Box 24J / 33a • NPI

1568791663

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

204C00000X (CMS 12)

Licensed & Credentialed Allopathic & Osteopathic Physicians — Neuromusculoskeletal Medicine, Sports Medicine

Box 32 Service Location & ZIP+4

1 MILLER RD, FARMINGDALE, NY, 11735-2015

✓ 9-Digit EDI 837 ZIP+4 (11735-2015)

Practice Phone & Referral Fax

(516) 755-5855

Fax: (516) 755-0330

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1568791663 (1 MILLER MEDICAL PC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1568791663` (NPI-2 Organization / Facility)
Provider / Legal Name	1 MILLER MEDICAL PC
Plain-English Specialty	Licensed & Credentialed Allopathic & Osteopathic Physicians — Neuromusculoskeletal Medicine, Sports Medicine NUCC Code: `204C00000X` (Neuromusculoskeletal Medicine, Sports Medicine)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	1 MILLER RD, FARMINGDALE, NY, 11735-2015
Practice Telephone / Fax	Tel: (516) 755-5855 \| Fax: (516) 755-0330
Administrative Mailing Address	1 MILLER RD, FARMINGDALE, NY, 11735-2015
Enumeration & Last Sync	Enumerated: 2009-12-18 \| CMS Record Updated: 2009-12-18
Authorized Official	STEVEN WONG (PRESIDENT)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

1 MILLER RD, FARMINGDALE, NY, 11735-2015

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Plain-English Taxonomy & CMS Crosswalk (204C00000X)

What Does Taxonomy Code 204C00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 204C00000X translates to:
"Licensed & Credentialed Allopathic & Osteopathic Physicians — Neuromusculoskeletal Medicine, Sports Medicine"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 12 (Physician/Osteopathic Manipulative Medicine) • CMS Code 23 (Physician/Sports Medicine)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Neuromusculoskeletal Medicine, Sports Medicine for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (1 MILLER MEDICAL PC)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`204C00000X` — Neuromusculoskeletal Medicine, Sports Medicine Plain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Neuromusculoskeletal Medicine, Sports Medicine	State: NY \| License: `188292` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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1 MILLER MEDICAL PC (NPI #1568791663)